The Altay Mountains’ forests are vital to Xinjiang’s terrestrial ecosystem, especially water regulation and conservation. This study evaluates vegetation evapotranspiration (ET) from 2000 to 2017 using temperature, precipitation, and ET data from the China Meteorological Data Sharing Service. The dataset underwent quality control and was interpolated using the inverse distance weighted (IDW) method. Correlation analysis and climate trend methodologies were applied to assess the impacts of temperature, precipitation, drought, and extreme weather events on ET. The results indicate that air temperature had a minimal effect on ET, with 68.34% of the region showing weak correlations (coefficients between −0.2 and 0.2). Conversely, precipitation exhibited a strong positive correlation with ET across 98.91% of the area. Drought analysis, using the standardized precipitation evapotranspiration index (SPEI) and the Temperature Vegetation Dryness Index (TVDI), showed that ET was significantly correlated with the SPEI in 96.47% of the region, while the TVDI displayed both positive and negative correlations. Extreme weather events also significantly influenced ET, with reductions in the Simple Daily Intensity Index (SDII), heavy precipitation days (R95p, R10), and increases in indicators like growing season length (GSL) and warm spell duration index (WSDI) leading to variations in ET. Based on the correlation coefficients and their significance, it was confirmed that the SII (precipitation intensity) and R95p (heavy precipitation) are the main factors causing vegetation ET increases. These findings offer crucial insights into the interactions between meteorological variables and ET, essential information for sustainable forest management, by highlighting the importance of optimizing water regulation strategies, such as adjusting species composition and forest density to enhance resilience against drought and extreme weather, thereby ensuring long-term forest health and productivity in response to climate change.